Multiple painful skin lesions

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A mother brought her 3-year-old son into the pediatrician with a complaint of multiple skin lesions on his thumb, which he frequently sucked for comfort. The grouped configuration of lesions were painful and had developed over the last 5 days to become vesicles. The doctor noted upon exam that he had a nearly healed cold sore on his lip, pain in his wrist, and an elevated temperature.

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